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肿瘤相关成纤维细胞调控CD8+ T细胞浸润的研究进展

Research Progress on Regulation of CD8+ T Cell Infiltration by Cancer-Associated Fibroblasts

  • 摘要: 肿瘤相关成纤维细胞(CAFs)是肿瘤微环境中的核心调控者,其高度异质性与可塑性深刻影响CD8+ T细胞的浸润与功能,从而决定免疫治疗响应。然而,CAFs导致CD8+ T细胞浸润障碍的机制在不同癌种中呈现显著差异。本文提出CAFs介导的免疫排斥二分法模型:Ⅰ型主动排斥,以胰腺导管腺癌为代表,CAFs通过过度沉积细胞外基质和分泌TGF-β/CXCL12构建物理与化学屏障;Ⅱ型免疫忽略,以部分微卫星稳定型结直肠癌为代表,CAFs功能缺失导致趋化因子不足。在此框架下,系统综述肌成纤维细胞样CAFs、炎症性CAFs等亚群在胰腺癌、三阴性乳腺癌、非小细胞肺癌、结直肠癌中的特异性调控机制,涵盖细胞外基质重塑、代谢重编程、免疫抑制网络构建等多维度作用。进一步整合单细胞与空间多组学视角,提出基于免疫分型的CAFs靶向策略:针对Ⅰ型肿瘤的“破障”策略(TGF-β抑制、FAP靶向)与针对Ⅱ型肿瘤的“激活”策略(CAFs重编程为免疫支持表型),并探讨其与免疫检查点抑制剂的时序性联合方案。

     

    Abstract: Cancer-associated fibroblasts (CAFs) are core regulators in the tumor microenvironment. Their high heterogeneity and plasticity remarkably influence the infiltration and function of CD8+ T cells, thereby determining the response to immunotherapy. However, the mechanisms by which CAFs impede CD8+ T cell infiltration exhibit substantial heterogeneity across different cancer types. This review proposes a dichotomous model of CAFs-mediated immune exclusion: Type Ⅰ active exclusion (exemplified by pancreatic ductal adenocarcinoma, where CAFs create physical and chemical barriers through excessive extracellular matrix deposition and secretion of TGF-β/CXCL12) and Type Ⅱ immune ignorance (exemplified by a subset of microsatellite-stable colorectal cancers, where loss of CAFs function results in insufficient chemokine production). Under this framework, we systematically review the specific regulatory mechanisms of CAFs subsets, specifically myofibroblastic CAFs and inflammatory CAFs, in pancreatic cancer, triple-negative breast cancer, non-small cell lung cancer, and colorectal cancer, highlighting their multidimensional roles in extracellular matrix remodeling, metabolic reprogramming, and construction of immunosuppressive networks. Furthermore, by integrating single-cell and spatial multi-omics perspectives, we propose immune phenotype-based CAFs-targeting strategies, namely, "barrier-breaking" strategies (TGF-β inhibition and FAP targeting) for Type Ⅰ tumors and "activating" strategies (reprogramming CAFs toward an immune-supportive phenotype) for Type Ⅱ tumors, and discuss their temporally sequenced combination with immune checkpoint inhibitors.

     

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